What is the treatment for fire coral (Millepora) envenomation?

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Last updated: April 30, 2025View editorial policy

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From the Guidelines

Treatment of fire coral stings should prioritize immediate removal from the water, rinsing the affected area with seawater, and applying vinegar to neutralize the toxins, as seen in the treatment of jellyfish stings 1. When dealing with fire coral stings, it's essential to:

  • Remove the victim from the water to prevent further stings
  • Rinse the affected area with seawater, not fresh water, to avoid activating the nematocysts further
  • Apply vinegar to the affected area to neutralize the toxins, similar to the treatment of jellyfish stings 1
  • Carefully remove any visible tentacles using tweezers or a credit card edge, avoiding direct contact with your fingers To manage pain and inflammation:
  • Take over-the-counter pain relievers like ibuprofen (400-600mg every 6 hours) or acetaminophen (500-1000mg every 6 hours)
  • Apply hydrocortisone cream (1%) to reduce inflammation
  • Use antihistamines like diphenhydramine (25-50mg every 6 hours) to control itching It's crucial to note that fire coral stings can cause severe reactions, including difficulty breathing, chest pain, or extensive rash, which require immediate medical attention 1. In such cases, epinephrine or stronger steroids may be necessary to manage the reaction. Most fire coral stings cause burning pain, redness, and itching due to the toxins released by the nematocysts, and symptoms typically resolve within 1-2 weeks 1. Avoiding sun exposure and keeping the area clean will help prevent secondary infection and promote faster healing.

From the Research

Treatment of Fire Coral

  • Fire coral contact is characterized by the immediate onset of burning pain caused by venom discharge from numerous tiny nematocysts located externally on the creature 2
  • Treatment consists of:
    • Saltwater irrigation of the wound
    • Nematocyst removal
    • Supportive care of the associated symptoms of pain, dermatitis, and pruritus 2

Associated Symptoms and Complications

  • Common symptoms include pain, dermatitis, and pruritus 2
  • Rarely, fire coral can cause systemic toxicity 2

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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